[Residual cavity evacuation following echinococcotomy-methods and results]

The results of operative management of liver hydatid disease are still estimated as unsatisfactory, with evacuation of the residual cavity after echinococcotomy a major problem faced. The study covers 100 patients, aged 15 to 75 years, presenting a total of 146 liver hydatid cysts, operated in the surgical diseases department of the Higher Medical institute--Pleven over the period 1992 through 1998. In 72 cases it is a matter of a solitary formation, and in the remainder (28) two or more cysts are present. A closed method is used in the operative management of 32 cysts, semiclosed (with or without autoplombage, capitonnage respectively)--in 98, and partial resection or pericystectomy--in sixteen. To monitor the residual cavity US imaging and/or CAT are employed. Surgical approaches and methods applied in the various locations, and the respective results obtained are discussed. Emphasis is laid on the safety afforded by the procedure including resection of the prominating fibrous wall (resection du dome saillant) and tight closure around the tubular drain. A maximum reduction of the residual cavity associated with the possibility of simultaneous evacuation of the exudate secreted reduce to a minimum the likelihood of persisting residual formation postoperatively.